Our Assumptions About Care in Old Age Are Just Wrong

Americans may talk like elder care is something you can just write a check to cover, but Stephanie H. Murray argues the onus is still landing squarely on families' shoulders. In a piece for the Atlantic, Murray opens by suggesting that the Netherlands—which spends 4.1% of its GDP on formal elder-care services, versus 1.3% in the US—serves as a reality check: Even there, almost half of older people who need help still lean on relatives or friends. In the US, more than 80% of elders who require care rely on family, and about two-thirds depend on informal help alone. "Chances are, your elder care will not be outsourced, at least not entirely," she advises.

Murray lays out why assuming "the system" or a facility will handle things is a mistake: many older adults resist institutional or in-home professional care, adult children are often far away or working full-time, and growing numbers of Americans don't have a spouse or kids at all. That leaves an emerging gap between who feels morally responsible (family) and who's actually nearby (neighbors who may hardly know us). The piece explores policy fixes and experimental "chosen family" care circles—and ends with this: "For most of us, truly preparing for old age will mean getting much more comfortable with asking for help and offering it to those around us, regardless of whether we're bound by blood or law." Read the full piece here.